Advancing Research • Shaping Policy • Developing Leaders

ISPS working paper

How private is medical and health data? Well-known cases of lost, stolen, or hacked computers or storage devices; reported snooping into celebrity data, or even that of neighbors or divorced spouses; and other computer breaches involving health records, are disturbing news.
This review makes three contributions. First, it addresses multiple issues and regulatory domains. Second, it therefore begins to describe a fuller legal landscape than the usual focus on one specific issue. Lastly, it takes a more patient-centric approach because more serious consideration of how to weigh conflicting needs, values, and theories is difficult without public, and hence legislative and regulatory, understanding. Data privacy threats and solutions come from both the public and private sectors.

Electronic health records, data sharing, big data, data mining, and secondary use are enabling exciting opportunities for improving health and health care while also exacerbating privacy concerns. Two court cases about selling prescription data raise questions of what constitutes “privacy” and “public interest;” they present opportunity for ethical analysis of data privacy, commodifying data for sale and ownership, combining public and private data, data for research, and transparency and consent. These interwoven issues involve discussion of big data benefits and harms, and touch on common dualities of the individual v. the aggregate or the public interest, research (or, more broadly, innovation) v. privacy, individual v. institutional power, identification v. identity and authentication, and virtual v. real individuals and contextualized information. Transparency and accountability are needed for assessing appropriate, judicious, and ethical data use and users, as some are more compatible with societal norms and values than others.

Two court cases that involve selling prescription data for pharmaceutical marketing affect biomedical informatics, patient and clinician privacy, and regulation.
Sorrell v. IMS Health, Inc. et al. in the US and R v. Department of Health, Ex Parte Source Informatics Ltd in the UK concern privacy and health data protection, data deidentification and re-identification, drug detailing (marketing), commercial benefit from required disclosure of personal information, clinician privacy and duty of confidentiality, beneficial and unsavory uses of health data, regulating health technologies, and considering data as speech. Individuals should, at the very least, be aware of how data about them is collected and used. Taking account of how that data is used is needed so societal norms and law evolve ethically as new technologies affect health data privacy.
and protection.

Most American gun owners have their firearms for a simple reason: protection. However, these estimates are based on nationally representative samples that are likely to undersample residents of marginalized urban communities where rates of violent victimization, and presumably the need for personal protection, are much higher than the country as a whole. Yet, we know very little about the motivations for gun acquisition within high-crime neighborhoods, especially among “hidden” sub-populations within these communities such as active criminal offenders. Drawing on past work linking neighborhood violence to legal cynicism, and using data gathered by the Chicago Gun Project (CGP), I employ measures of police legitimacy to explore the effect of distrust of legal agents on protective gun ownership among active offenders in Chicago. These data confirm that lower levels of police legitimacy are significantly related to a higher probability of acquiring a firearm for protection. I also consider the ways that gang membership, legal changes in Chicago, and gun behaviors are related to protective gun ownership.

Over the past two decades, the United States has experienced an unpredicted drop in crime. Chicago, while often portrayed as a violent city, has seen sustained drops in violent crime and homicide rates during this time, but particularly recently. Using annual crime data, this report briefly describes temporal and spatial trends of major index crime in Chicago from 1965 to 2013. Overall, Chicago—like other U.S. cities—experienced a significant decline in overall crime and violent crime. Present day levels of violent crime are, in fact, at their lowest rates in four decades. Furthermore, nearly all communities experienced declines in crime, although the rates of decline were greater in some communities than others. Over the past three years, for example, all but five communities (out of 77) experienced declines in violent crime. Those areas that experienced increases were and continue to be some of Chicago’s safest areas. While the drop in violent crime is shared between low and high crime areas alike, there remain areas of the city where violent crime rates are unacceptably high. Rates of homicide have also decreased over this period following the overall city-wide pattern, with some unique patterns emerging surrounding the contexts of gang homicide. The objective of this report is to simply document these historical trends and not to assign any casual interpretations of the vanguards of crime rates of this period. Directions for future investigation are also discussed.

There is conflicting laboratory and field evidence on the effectiveness of gift exchange -- the exchange of above-market wages for above-minimal effort -- as an incentive mechanism. We investigate this conflict by theoretically identifying the factors dampening gift exchange in the field -- habituation to the gift, fatigue, and small gift size -- and by subsequently implementing a field experiment tailored to avoid them as well as two others: selection of better workers and ambiguous kindness signals. Still, we find no evidence of gift exchange in the field. Additional tests suggest this was not due to an effort ceiling. Further, a subsequent laboratory experiment investigating whether the absence of gift exchange could be driven by a want of reciprocal workers, shows that a substantial portion behaved prosocially in laboratory, but failed to engage
in gift exchange in the field. All workers, however, responded to piece rates. Our results favor a classical model of preferences.

The 2008-2010 campaign to pass climate legislation was one of the largest efforts in the history of energy and environmental politics. Yet despite initial legislative success in the House of Representatives in early 2009 and the strong forces arrayed in support of a climate bill, the Senate dropped the issue from consideration in the summer of 2010. Such a high profile defeat might be expected to attract substantial academic attention. However, nearly three years out little analysis has been forthcoming.
This paper addresses that gap in current scholarship, seeking to both inform academic understanding of climate politics and provide insights to practitioners and policymakers. The analysis is structured into two main sections. The first section examines four key barriers that protected the policy status quo: partisan polarization, political geography, energy interests and the recession. Through comparison with the Affordable Care Act and the history of U.S. environmental policymaking, the second section suggests three political forces that might have helped strength the climate campaign: public opinion, grassroots mobilization and presidential leadership. It further suggests that the failures of the climate campaign to pay sufficient attention to opinion and mobilization are symptomatic of broader challenges facing an increasingly professionalized and Washington-based environmental movement.

The current field experiment investigates how differential treatment of minority members changes during real world social interactions. Three Latino and three White males were randomly assigned to make check purchases in 217 retail stores and to present either an official or unofficial ID. Several indicators of differential treatment were assessed across time in the customer cashier interactions. At the beginning, Latino confederates were (a) quoted a higher minimum dollar amount for the gift-certificate they requested, (b) asked for ID more often, and (c) frowned at more frequently than White confederates. Later in the interaction cashiers were equally likely to accept an official ID from Latinos than Whites but more likely to accept an unofficial ID from Latinos than Whites. Thus, we observed a change in differential treatment over the course of the customer cashier interaction. These findings illustrate the importance of studying differential treatment across time using field-experimentation.

Freedom of information laws empower the interested parties to access all documents held by the government with only a few and stated exceptions. The question is: do governments guarantee equal information provision regardless of people’s power and status? I executed a randomized experiment to investigate the effect of income and political connections on the provision of government information. Two hundred and forty one information requests were sent to the Mexican federal government. A regular male civilian with a very common last name sent half. The second half were sent by a male that signaled having wealth and political connections. Overall, the results show that the average citizen received a very similar treatment compared to the citizen that signaled wealth and political connections. The study did uncover some differential treatment based on status. The wealthy and politically connected citizen seemed to be promised more information and, therefore, a better service.